Client Case Study: 32 year old Male with Hair Loss
Brad was a 32 year old male leading a high-demand division in a start-up company. He also volunteered on the local fire department, which often led to feeling highly stressed and then wired-but-tired. He came to me with a main concern of circular patches of hair loss that had suddenly appeared over the course of a few days to weeks. Each spot would start out looking like a simple knick from the hair clippers, however would grow over the course of 1-2 weeks to a circular patch of hair loss, reaching the size of a quarter. He had 2 clear spots at the time of seeking my help with this and was deeply concerned about further growth of the spots, but also increase in number. Here’s how we worked together to reverse the hair loss and up level his overall health to support him in his high-stress role.
Holistic Review & Labwork
Brad had never had a comprehensive review of his health history, nor had he really had in-depth lab work. We started there by reviewing his entire health history- hospitalizations, surgeries, major medical events, and allergies, as well as his day to day diet, routine, habits, and intake of alcohol, stress, and more.
I ordered comprehensive blood work to give us an idea of any possible underlying concerns. Labs included comprehensive metabolic panel (CMP) to evaluate major organ system function, complete blood count (CBC) to evaluate nutrients and immune function, an iron panel & ferritin for evaluating iron status, vitamin D, thyroid labs (TSH, Free T3, Free T4 and thyroid antibodies), and fasting insulin. Since my top suspicion for diagnosis was Alopecia Areata and this is often linked with auto-immunity, I also ordered inflammatory markers such as C-reactive protein (CRP) & Erythrocyte Sedimentation Rate (ESR) and autoimmunity markers such as antinuclear antibody (ANA) and Rheumatoid Factor (RF). I had concerns about hormone function and testosterone levels based on his medical history of two major TBI/concussions at a young age, however we prioritized the most pertinent labs for the hair loss patches, knowing that this particular presentation is rarely associated with hormone imbalance.
In addition to blood labs, I ordered a 4 point saliva cortisol test, which he would collect at 4 different points throughout the day (upon waking, at noon, in the afternoon, and at bedtime), to give us insight on his adrenal function since cortisol is a stress hormone produced by the adrenal glands.
Brad’s labs were largely within optimal limits (note: when I look at labs, I’m looking at them from a perspective of wanting clients to be optimal, not just “normal”). Vitamin D was lower than ideal at 35 ng/dL, however all other labs were optimal. Autoimmune markers were negative, indicating that autoimmunity was not likely the biggest contributing factor to Brad’s particular presentation of alopecia areata.
Brad’s cortisol curve was not only inverted (lowest in the morning, with a spike in the afternoon and then low again in the evenings), he reported that it was nearly impossible for him to make it through this testing day, due to needing to avoid caffeine for the most accurate results.
Nervous System Nourishment
Based on Brad’s labs and presentation of hair loss, alopecia areata was the most likely diagnosis, and it didn’t seem to be stemming from an overt autoimmune reaction. The clearest contributing factor was high stress, which he rated 10/10 in terms of severity (10 = highest). The hair loss also started around the same time that stress increased to that level and had sustained at that point for several weeks. Because of this, we prioritized stress management and nervous system nourishment.
Support for this included:
Regular structured meals with adequate protein, fat and carbohydrate as well as priority on micronutrients through variety of colors.
Swapping out his 2nd mid-morning coffee for green tea or matcha, and aiming for eliminating the afternoon coffee altogether. If he felt like he needed something for energy in the afternoon, when a quick walk outside or other strategies wouldn’t work, he would opt for green tea again vs. coffee.
Stress management/balancing practices such as meditation, morning walk, delegating, breath work, somatic practices and more. He was interested in health tech, so we used the Heart Math program for optimizing Heart Rate Variability (HRV).
Digestion-optimizing strategies: reducing “working lunches” whenever possible. Eating in a low-stress environment, eating while seated, and chewing each bite well.
Adaptogenic herbs target towards his specific needs. In Brad’s case, Ashwagandha and Eleuthero were a great fit. My approach with adaptogens is to tailor them to the needs of the client. There is no one-size-fits-all approach!
Targeted Remedies
Alopecia areata can have a number of different potential contributing factors, which makes uncovering the root cause for each case imperative for determining the targeted support I choose.
In Brad’s case, the leading root cause was stress. Along with other support, we used homeopathic support specific for hair loss after stress. Homeopathic remedies are highly individualized and based on the case presentation and needs. I use a system called Biotherapeutic Drainage, which are combination homeopathic remedies that work to restore function to organ systems. These remedies helped Brad’s hair regrow.
I created a mixture of castor oil, jojoba oil, and essential oils of rosemary and cedar wood, which Brad applied to the areas of hair loss nightly. This blend helped support blood flow to the scalp, to encourage nutrient delivery and hair re-growth.
Foundational Support
Foundational support is often the first pillar I work on with clients. The foundations of health include diet, sleep, movement, and digestion. When foundations are off or imbalanced, it becomes more challenging for the body to heal due to not having appropriate nutrients, elimination, or repair/restorative time.
Brad was getting to sleep easily, but wasn’t waking feeling well-rested every morning. This indicated that he needed better quality sleep. A simple solution that worked well for him was adding magnesium glycinate at bedtime, which he found resulted in more restful sleep, less tossing and turning during the night, and feeling calm and alert upon waking in the morning.
I consider routes of elimination (digestion/stool, urine, sweat, etc.) as a foundational aspect of health, so along with targeted support, we were working on optimizing these pathways at the same time. Optimizing digestion helped him maximize absorption of nutrients from his food, and as an added benefit, he noticed bowel movements were more reliable and gas reduced.
Brad was already an avid exerciser. Some of his workouts were creating more stress on the body, so we re-engineered a program that reduced additional stress. He started walking daily in the morning as a foundational practice, and then reduced strength training to 3-4 times per week with appropriate rest between sets and built-in days for recovery. We also swapped out long endurance-focused runs for 1-2 mile jogs, being mindful of keeping heart rate within an appropriate zone for him.
Nutrition was key for Brad. While we were optimizing digestion, sleep, and stress-response, he was committed to a nutrient-rich diet that would fuel his high-demand job and life.
Using foundational and targeted strategies, we noticed regrowth starting of Brad’s hair within 2 weeks. The spots of hair loss were mostly filled in within 2 months, and hair had fully regrown within 3 months. While the patches of hair loss were Brad’s main concern, he also experienced increased energy, more reliable digestion, better sleep quality, and reported improved focus as a result of all the work we had done together. He also regained confidence to show up in his high pressure job that had been damaged when he started to experience hair loss. Naturopathic & holistic care supports the body from the inside, out, giving sustainable solutions to every day concerns.